DVA’s provisional medical access scheme unfairly prioritises claimants and should be scrapped
Op-ed by Brian Briggs … Brian Briggs is a military compensation law expert at Slater and Gordon Lawyers
Clearing the backlog of more than 60,000 injury claims in its troubled online processing system could be achieved a lot faster by the Department of Veterans Affairs if it ended the Provisional Access to Medical Treatment trial (PAMT).
Having spent more than a decade helping veterans obtain compensation for injuries and illnesses related to their service, I can’t understand why the scheme has repeatedly been extended. It has not only contributed to the unmanageable backlog but unfairly prioritises treatment for certain claimants over others who may be just as, if not more, deserving.
Introduced with good intention in 2018, PAMT enables veterans to access medical treatment at the department’s expense for the 20 most commonly accepted injury conditions on a provisional basis while liability is being considered.
Liability refers to DVA acknowledging and accepting responsibility for the injury, entitling the claimant to medical treatment and benefits such as incapacity payments, support payments for personal care or household services, mobility aids, repair and maintenance, and lump-sum compensation.
Back, knee and shoulder injuries, joint instability, fractures, dislocations, sprains and strains and hearing loss are all included among the scheme’s common conditions. Irrespective of whether liability is ultimately accepted, veterans who suffer these conditions can go online and lodge a claim and immediately receive treatment such as physiotherapy and surgery. Proof of how their injury relates to their service is not required, nor do they have to provide evidence about why the treatment is needed.
Within months of the trial’s introduction, DVA slashed the number of staff in its claims department to the point that it did not have enough resources to cope with the unexpectedly high volume of claims that were subsequently received.
And veterans whose injuries fall outside of PAMT have been inadvertently caught up in the backlog of claims awaiting determination. This has led to many claimants’ injuries deteriorating further and left some financially destitute.
I know of veterans who have waited more than 18 months for their claims to be assigned to a DVA claims delegate for investigation, let alone have liability admitted so they can receive treatment and other benefits. Meanwhile, others, whose injuries have no connection to their service at all, have received treatment straight away.
I believe some veterans who have minimal service that served many years ago are exploiting this program knowing that liability for the condition will never be accepted by the department.
There have been multiple reviews and inquiries into the causes of DVA’s claims processing delays, which combined with the department’s inability to meet growing claims demands, is again being explored by the Royal Commission into Defence and Veteran Suicide. This is because the delays have been raised as a factor in some veterans taking their own lives.
But instead of waiting years for the Royal Commission to release its findings, the department should act now to stop veterans from waiting any longer to access their lawful entitlements.
Ending the PAMT trial will stop the claims backlog from blowing out even further and ensure that all claimants are treated equally once again.
It will also show that the department is serious about improving the health and welfare of veterans while saving the lives and livelihoods of those injured while serving our country in the process.